Early and Long-Term Results of Minimally Invasive Mitral Valve Repair in Young and Middle-Aged Patients

Keywords: mitral valve insufficiency, thoracotomy, artificial chords, annuloplasty ring, postoperative complications, simultaneous plastic surgery

Abstract

The aim. To analyze the early and long-term results of minimally invasive mitral valve repair in young and middle-aged patients and compare the outcomes with mitral valve repairs performed through standard sternotomy.

Materials and methods. From 2016 to 2021, 128 patients with mitral insufficiency were operated in the Ukrainian Children’s Cardiac Center. Exclusion criteria included patients under 18 or over 59 years old and patients with concomitant pathology of the aortic valve, aorta, and coronary arteries.

Results. In the investigated group, the average duration of cardiopulmonary bypass and aortic cross-clamping time was longer than in the comparative group. However, the average duration of mechanical ventilation, average time in theintensive care unit, and average length of hospitalization were shorter in the investigated group. Patients in the investigated group less frequently required red blood cell transfusion (5.6% vs. 14.6%) and plasma transfusion (9.4% vs. 14.6%). The percentage of postoperative complications was almost half lower in the investigated group (3.6% vs. 6.6%). None of the patients in the investigated group showed a severe degree of mitral insufficiency, while two patients in the comparative group had severe mitral insufficiency.

Conclusions. Minimally invasive mitral valve repair is associated with a lower percentage of postoperative complications. Early and long-term observation results indicate the high effectiveness and safety of the minimally invasive method.

References

  1. Aluru JS, Barsouk A, Saginala K, Rawla P, Barsouk A. Valvular Heart Disease Epidemiology. Med Sci(Basel). 2022 Jun 15;10(2):32. https://doi.org/10.3390/medsci10020032
  2. Tersalvi G, Gaiero L, Capriolo M, Cristoforetti Y, Salizzoni S, Senatore G, et al. Sex Differences in Epidemiology, Morphology, Mechanisms, and Treatment of Mitral Valve Regurgitation. Medicina (Kaunas). 2023 May 24;59(6):1017. https://doi.org/10.3390/medicina59061017
  3. Cohn LH, Tchantchaleishvili V, Rajab TK. Evolution of the concept and practice of mitral valve repair. Ann Cardiothorac Surg. 2015;4(4):315-321. https://doi.org/10.3978/j.issn.2225-319X.2015.04.09
  4. Ritwick B, Chaudhuri K, Crouch G, Edwards JR, Worthington M, Stuklis RG. Minimally Invasive Mitral Valve Procedures: The Current State. Minim Invasive Surg. 2013;2013:679276. https://doi.org/10.1155/2013/679276
  5. Sá MPBO, Van den Eynde J, Cavalcanti LRP, Kadyraliev B, Enginoev S, Zhigalov K, et al. Mitral valve repair with minimally invasive approaches vs sternotomy: A meta-analysis of early and late results in randomized and matched observational studies. J Card Surg. 2020;35(9):2307-2323. https://doi.org/10.1111/jocs.14799
  6. Mkalaluh S, Szczechowicz M, Dib B, Sabashnikov A, Szabo G, Karck M, et al. Early and long-term results of minimally invasive mitral valve surgery through a right mini-thoracotomy approach: a retrospective propensity-score matched analysis. PeerJ. 2018 May 28;6:e4810. https://doi.org/10.7717/peerj.4810
  7. Eltonsy AM, Elborae WS, Elkay HM, Ali HF. Early Outcome of Minimally Invasive Versus Conventional Mitral Valve Replacement Surgery. Egypt J Hosp Med. 2023;90:186-193. https://doi.org/10.21608/ejhm.2023.279308
  8. Pojar M, Karalko M, Dergel M, Vojacek J. Minimally invasive or sternotomy approach in mitral valve surgery: a propensity-matched comparison. J Cardiothorac Surg. 2021 Aug 10;16(1):228. https://doi.org/10.1186/s13019-021-01578-9
  9. Cetinkaya A, Geier A, Bramlage K, Hein S, Bramlage P, Schönburg M, et al. Long-term results after mitral valve surgery using minimally invasive versus sternotomy approach: a propensity matched comparison of a large single-center series. BMC Cardiovasc Disord. 2021 Jun 26;21(1):314. https://doi.org/10.1186/s12872-021-02121-3
Published
2024-06-27
How to Cite
1.
Tsvyk AS, Gorbatiuk VI, Krykunov KO, Yemets GI, Telehuzova OV, Chernetskyi YO. Early and Long-Term Results of Minimally Invasive Mitral Valve Repair in Young and Middle-Aged Patients. ujcvs [Internet]. 2024Jun.27 [cited 2024Dec.26];32(2):80-5. Available from: https://cvs.org.ua/index.php/ujcvs/article/view/651